Transfusion and Apheresis Science xxx (xxxx) xxx Please cite this article as: Massimo Martino, Transfusion and Apheresis Science, https://doi.org/10.1016/j.transci.2020.102911 Available online 24 August 2020 1473-0502/© 2020 Elsevier Ltd. All rights reserved. Granisetron transdermal system and dexamethasone for the prevention of nausea and vomiting in multiple myeloma patients receiving chemo-mobilization: An observational real-world study of effectiveness and safety Massimo Martino a, *, Virginia Naso a , Gaetana Porto a , Annalisa Paviglianiti a , Anna Ferreri a , Barbara Loteta a , Tiziana Moscato a , Giuseppe Console a , Massimo Gentile b , Marco Rossi c , Pasquale Fabio Provenzano a , Mercedes Gori d , Anna Lisa Pitino d , Antonella Morabito e , Giovanni Tripepi f a Stem Cell Transplantation and Cellular Therapies Unit, Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy b Hematology Unit, Department of Onco-Hematology, A.O. of Cosenza, Cosenza, Italy c Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy d CNR-IFC, Rome, Italy e Pharmacy Unit, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy f CNR-IFC, Research Unit of Reggio Calabria, Reggio Calabria, Italy A R T I C L E INFO Keywords: Granisetron Transdermal Multiple myeloma Mobilization Nausea Vomiting ABSTRACT PURPOSE: Cyclophosphamide (CY) in a dose of 2–4 g/m 2 is widely used for hemopoietic progenitor stem cells mobilization. CY administration is associated with several adverse effects, including chemotherapy-induced nausea and vomiting (CINV). This study aimed to evaluate the efficacy and tolerability of granisetron trans- dermal system (GTDS) plus dexamethasone in the management of CINV in MM patients undergoing chemo- mobilization with CY. METHODS: In this single-center, prospective, observational, real world study, GTDS plus dexamethasone was administered to MM patients receiving chemo-mobilization based on CY 2 g/m2 plus G-CSF in an outpatient setting. The rate of complete response was evaluated as the main outcome. Other outcomes were rate of complete control of CINV, incidence of nausea/vomiting of any grade and safety. RESULTS: A total of 88 patients were enrolled. A complete response was achieved in 45.5 % of patients; among them, 39.77 % attained complete control of CINV. Nausea and vomiting never occurred in 34.1 % and 45.5 % of patients, respectively. No episodes of grade 3–4 nausea and/or vomiting were documented. GTDS was safe and well tolerated. CONCLUSION: In real world, GTDS provided an innovative, effective, and well-tolerated control of CINV in MM patients after chemo-mobilization with CY. The study found out effectiveness of a non-invasive delivery system of antiemetic. 1. Introduction The treatment landscape for multiple myeloma (MM) has been remodeled by the introduction of novel agents, including immuno- modulatory drugs, proteasome inhibitors, and monoclonal antibodies [1–6]. Despite the impressive advances of recent years, high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) is still considered a standard of care in eligible patients [7,8], and MM remains the main indication for ASCT worldwide [9,10]. The introduction of novel drugs administered before and/or after HDC plus * Corresponding author at: Stem Cell Transplant Program, Clinical Section, Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Giuseppe Melacrino, 21, 89124 Reggio Calabria RC, Reggio Calabria, Italy. E-mail address: massimo.martino@ospedalerc.it (M. Martino). Contents lists available at ScienceDirect Transfusion and Apheresis Science journal homepage: www.elsevier.com/locate/transci https://doi.org/10.1016/j.transci.2020.102911 Received 24 May 2020; Received in revised form 6 August 2020; Accepted 6 August 2020